This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Wednesday, March 05, 2014

Pre - Budget Review Of The Health Sector - 5 March 2014.

As we head towards the Budget in Late May 2014 I thought It would be useful to keep a closer eye than usual on what was being said regarding what we might see coming out of the Budget.

According to the Australian Parliament web site Budget Night will be on Tuesday 13th May, 2014.

Here are some of the more interesting articles I have spotted this week.

Tony Abbott has flagged a reduction in the rate of spending growth in health and education, but insists he will keep his election promise of no cuts in those areas.

In a speech to the Australia-Canada Economic Leadership Forum on Monday night, the Prime Minister backed his Treasurer, Joe Hockey, in preparing Australians for a tough budget and for inevitable curtailing of government programs.

''We will keep our pre-election commitments to maintain health spending and school spending but we must reduce the rate of spending growth in the longer term,'' Mr Abbott said.

The Prime Minister's warning about health and education spending follows media appearances last week by Health Minister Peter Dutton, and Mr Hockey, in which they suggested that the current rate of government spending was unsustainable.

Prime Minister Tony Abbott will go to the next election promising spending cuts to health and education as part of the government’s long-term strategy to balance the budget.

The cuts are likely to be included in the May budget but would not begin until the final year of the four-year budget cycle, which would place them beyond the next election.

“We will keep our pre-election ­commitments to maintain health spending and school spending but must reduce the rate of spending growth in the longer term if debt is to be paid off and good schools and hospitals are to be sustainable in the longer term,’’ Mr Abbott told the Australia-Canada Economic Leadership Forum.

He said Australia would follow the Canadian, UK and New Zealand ­governments in cutting taxes, reducing spending growth and tackling ­regulation to rebalance the budget.

AUSTRALIANS could pay between $6 and $36 to see a doctor when they get the flu under wide ranging health reforms floated by Health Minister Peter Dutton.

The cost of an X-ray of the leg could rise from zero to $10, and a blood test could cost $2.50 under plans the government is considering that would see access to bulk billing means tested.

Such fee increases could be the consequences of plans floated by Mr Dutton last week that could see people who can afford to do so contribute more to the cost of their care.

“I want to make sure ... we have a discussion about whether you or me, on reasonable incomes, should expect to pay nothing when we see the doctor, when we go to have a blood test should we expect to pay nothing as a co-contribution?” Mr Dutton said last week.

More than 80 per cent of visits to the GP, 87 per cent of pathology tests and 73 per cent of X-rays are currently bulk billed which means patients pay nothing.

Community pharmacies could be pushed to their limits if the Federal Government fails to offset the impact Simplified Price Disclosure will have on their viability, the Pharmacy Guild of Australia believes.

In a letter to pharmacy owners, George Tambassis, Guild national president, said the organisation would “not relent” until the Government agreed to provide compensation to the profession for the cuts, which were announced prior to last year’s Federal Election.

However, Mr Tambassis said that while Peter Dutton, the Minister for Health, was “sympathetic to pharmacy”, he had informed the Guild that “he does not have the money” to compensate pharmacy for the impact of Simplified Price Disclosure.

“I have personally made clear to him that the Guild will not relent until this issue is satisfactorily addressed,” Mr Tambassis said.

Catherine King

If the changes to Australia's health system being signalled by the Abbott government are enacted, Medicare will exist in name only.

Thirty years ago this month Medicare was established on the principle that all Australians should have equal access to healthcare. Universal healthcare is a cornerstone of our social safety net and central to the commitment we have for each other's health and welfare.

If Peter Dutton wants to have a conversation about health expenditure, let's do it with facts, not as a political tactic by those who have opposed universal health care from the beginning.

When Medicare was introduced Australia didn't have a universal healthcare system. Bob Hawke as prime minister warned that without it 2 million people ''faced potential financial ruin in the event of major illness''.

Treasurer Joe Hockey and health minister Peter Dutton have been in overdrive this past week lowering expectations for the May budget and reminding Australians that its 30-year-old Medicare system is “unsustainable”.

Treasurer Joe Hockey and health minister Peter Dutton have been in overdrive this past week lowering expectations for the May budget and reminding Australians that its 30-year-old Medicare system is “unsustainable” and, if we’re not careful, Australia will run out of money to pay for health care.

Health minister Peter Dutton said he wanted to start a conversation about whether it’s fair to charge patients to see their general practitioner. He’s also suggested that allowing private insurance to cover part of the cost of medical fees will reduce public spending.

As others have already pointed out, these proposals won’t solve a thing. A flat co-payment for doctor visits will not raise much revenue and will reduce access to those most in need. Allowing private health insurers to pay for out-of-pocket costs to see a general practitioner will lead to a rise in fees and an increase in total health spending.

A more efficient way to pay for the increasing cost of universal health care is to raise taxes and to improve efficiency.

Chief political correspondent

Suspension of disbelief is an oft-used tool in national politics. Which is why no one flinched in question time on Tuesday as Labor branded a Medicare co-payment, floated by federal Health Minister Peter Dutton to contain costs, as ''the proposed GP tax''.

A potentially worthy policy idea converted into a certainty and reduced to a powerful negative slogan. Who knew? For Labor, it was a soda. Easy money. Politics 101 with the arsenic tang of payback thrown in.

Cue the pantomime acting on the government side as frontbenchers' heads rolled back in mock incredulity, flabbergasted at such an unworthy suggestion.

PRIME Minister Tony Abbott has said his government has no plans to introduce a “GP tax”, telling parliament of his admiration for GPs as the backbone of the nation’s health system.

Answering questions in the House of Representatives yesterday, Mr Abbott said he believed the “average Australian GP does a very good job, often under difficult circumstances, and we want to support general practice”.

In response to a question from shadow health minister Catherine King about whether he believed there was over-servicing in general practice and whether Australians went to their GP too often, Mr Abbott said he had “nothing but admiration and respect for the GPs of Australia”.

Economics correspondent

Spending on health is sustainable precisely for the reason that we want to sustain it.

Unsustainable? A generation ago the veteran Labor MP Barry Jones led an inquiry into expectations of life in the 21st century. He said the question was being framed as whether Australia could "afford" an ageing population. "At first sight this seems an ordinary sort of accountant's question," he reported. "Like: can we afford a new car?''

"But decisive differences emerge when we consider the answers. If we can't afford a new car, we don't buy one, and nobody suffers. But what if we decide that we can't afford the coming increase in the aged population?"

The argument over $6 GP co-payments is little more than a distraction from the real task - untangling our incoherent system of health funding, writes Ian McAuley

Health Minister Peter Dutton is on the right track when he says he wants “to start a national conversation about modernising and strengthening Medicare”.

Our health arrangements serve us well, but as John Dwyer, Emeritus Professor of Medicine at UNSW, pointed out in an ABC interview last week, there are inefficiencies to be addressed. There are what economists call technical inefficiencies — too many bureaucrats in overlapping state and federal jurisdictions and in private insurance firms, poor use of information technology, rigid workforce demarcations and a lack of integration between different care providers. That’s just to name a few!

More seriously there are what economists call allocative inefficiencies — in particular high attention to treating illness contrasting with neglect of public health measures which could prevent illness.

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Comment:

It seems even clearer there is a significant change coming on the basis of this week’s news. The PM and Treasurer are making it clear that cuts are coming in what might be termed low return areas (read low political threat areas) and that the rate of growth of health spending will plateau pretty quickly.

3 comments:

Any co-payment for services where no payment is currently collected will increase administration costs. It seems more trouble than it's worth to have the additional time, transaction costs, printing receipts and reporting required. Software and work flows would have to be changed. Would the GP practice charge the patient at time of writing the pathology request or will the patient have to make an extra trip to the path lab to pay the fee before anyone can see the results.

General practice is a good gatekeeper to control access to other specialists and services. GP visits are also required for prevention, early detection, early treatment and management of existing conditions with the aim of minimising future hospitalisation. Discouraging patients from using a GP will lead to increased hospital costs and reduce life expectancy far greater than any saving from GP cost savings.